Document Detail


Incidence and clinical course of lercanidipine-associated cloudy effluent in continuous ambulatory peritoneal dialysis.
MedLine Citation:
PMID:  20860906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lercanidipine, a novel dihydropyridine calcium channel antagonist, has been reported to cause sterile cloudy effluent in patients on continuous ambulatory peritoneal dialysis (CAPD). The purpose of the study was to evaluate the incidence and clinical course of cloudy effluent associated with lercanidipine in uremic patients on CAPD. METHODS: We designed a consecutive observation study in 40 non-diabetic uremic patients on CAPD treated with lercanidipine 5 mg daily. Lercanidipine-induced cloudy effluent was defined as acellular and culture-negative effluent associated with the use of this drug and exclusion of other causative factors. Time to develop cloudy effluent, dwell effluent amount and the associated symptoms were recorded. Baseline peritoneal membrane characteristics, net ultrafiltration per session and routine biochemistry in serum and dialysate were compared between patients with and without the development of cloudy effluent. RESULTS: 9 patients (22.5%) developed cloudy effluent within 2 days of lercanidipine initiation. The triglyceride concentration in cloudy effluent was greater than 10 mg/dl (19.3 ± 6.3 mg/dl). There was a significant increase in dwell effluent amount (93.3 ± 64 ml/exchange, p < 0.05). Clinical symptoms as abdominal cramping or fullness were observed in 3 patients. All cloudy effluent disappeared after ceasing lercanidipine but recurred after resumption of lercanidipine. Baseline dialysate to plasma (D/P) creatinine ratio (0.7 ± 0.1 vs. 0.51 ± 0.1; p = 0.07) tended to be higher and dialysate total protein (93.4 ± 33 vs. 61.5 ± 24 mg/dl; p < 0.05) were significantly higher in patients with than without the development of cloudy effluent. CONCLUSION: The incidence of lercanidipine-associated cloudy effluent is relatively higher with transient benign clinical symptoms. Patients with lercanidipine associated cloudy effluent tend to have a higher membrane transport with an increased effluent amount.
Authors:
P-J Hsiao; H-W Lin; C-C Sung; C-W Wang; P Chu; S-H Lin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  74     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-23     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  217-22     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Calcium Channel Blockers / pharmacology*
Dialysis Solutions / metabolism*
Dihydropyridines / pharmacology*
Female
Humans
Male
Middle Aged
Nephelometry and Turbidimetry
Peritoneal Dialysis, Continuous Ambulatory*
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Dialysis Solutions; 0/Dihydropyridines; 100427-26-7/lercanidipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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